- Enrollment id
- O20221114000940
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1154997997
- Multiple npi flag
- N
- Ccn
- 757197
- Associate id
- 8921489006
- Organization name
- UNCONDITIONAL CARE HOME HEALTH
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 300 N 3RD ST
- Address line 2
- STE 306
- City
- BURBANK
- State
- CA
- Zip code
- 915021107